Ummar Syed, Dorai B Lakshmi, Ramanathan Shree Aarthi
Department of Psychiatry, PSG Institute of Medical Science and Research, Coimbatore, Tamil Nadu, India.
Department of Psychiatry, Vinayaga Mission's Kirupananda Variyar Medical College, Salem, Tamil Nadu, India.
Indian J Psychiatry. 2016 Oct-Dec;58(4):383-386. doi: 10.4103/0019-5545.196708.
To assess the incidence of cutaneous lesion in bipolar affective disorder (BPAD) patients on lithium therapy. To evaluate the relationship between duration of lithium therapy, dosage of lithium, serum lithium level, and cutaneous lesions. To assess whether reduction/stoppage of dose of lithium has any change in the course of cutaneous side effects. To look for a relationship between addition of isotretinoin and the course of mood disorder.
We retrospectively collected hospital case records of 125 consecutive BPAD patients initiated lithium therapy, assessed with inclusion and exclusion criteria. We follow up them for 2½ years for the assessment of above said aims.
The prevalence of skin reaction in BPAD patients with lithium therapy was 19.8%. Among patients on lithium therapy, cutaneous lesion emerged in initial 6 months and later after 1 year of treatment. Nearly 55% of patients on higher doses of lithium (1200 mg) had a cutaneous lesion. Patient on therapeutic serum level of lithium had a higher incidence of skin lesion. Out of six patients in whom dosage of lithium was reduced, three of them had reduced lesions ( = 0.6), in two patients, skin lesion increased, and one patient had no change. Among 11 patients treated with isotretinoin, only two patients had emergence of depressive symptoms.
Lithium continues to increase the incidence of multiple cutaneous lesions among BPAD patients on lithium therapy. Incidence of cutaneous side effects directly correlates with the dose of lithium and therapeutic range of serum lithium level. Altering the dose of lithium does not statistically influence the cutaneous lesion.
评估接受锂盐治疗的双相情感障碍（BPAD）患者皮肤病变的发生率。评估锂盐治疗时长、锂盐剂量、血清锂水平与皮肤病变之间的关系。评估锂盐剂量减少/停用是否会使皮肤副作用的病程发生变化。探寻加用异维A酸与心境障碍病程之间的关系。
我们回顾性收集了125例连续接受锂盐治疗的BPAD患者的医院病例记录，并根据纳入和排除标准进行评估。我们对他们进行了2.5年的随访，以评估上述目的。
接受锂盐治疗的BPAD患者皮肤反应的患病率为19.8%。在接受锂盐治疗的患者中，皮肤病变出现在治疗的最初6个月以及1年后。近55%服用高剂量锂盐（1200毫克）的患者出现皮肤病变。血清锂水平处于治疗范围的患者皮肤病变发生率更高。在6例锂盐剂量减少的患者中，3例病变减轻（P = 0.6），2例患者皮肤病变加重，1例患者无变化。在11例接受异维A酸治疗的患者中，只有2例出现抑郁症状。
锂盐持续增加接受锂盐治疗的BPAD患者多种皮肤病变的发生率。皮肤副作用的发生率与锂盐剂量和血清锂水平的治疗范围直接相关。改变锂盐剂量在统计学上对皮肤病变没有影响。
